From SOUL BEAT AFRICA - where communication and media are central to AFRICA's social and economic development
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This edition of The Soul Beat looks at the role of communication in tuberculosis (TB) prevention and treatment. The newsletter offers a selection of programme experiences, strategic thinking documents and materials from the Soul Beat Africa website which highlight how social mobilisation, advocacy, and community participation, as well as communication campaigns, the media, and information and communication technologies (ICTs) can contribute towards preventing and effectively treating TB in Africa.
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OVERVIEW
1. The Global Plan to Stop Tuberculosis (2006-2015)
Published by the Stop TB Partnership, this report offers a comprehensive assessment of the action and resources needed to implement the Stop TB strategy and make an impact on fighting TB. In terms of knowledge and communication, the document states that there is still limited awareness of TB. Stigma and poor knowledge about what types of TB services are available and effective contribute to underuse of services and to the social costs of TB. Where quality services are available and truly accessible, it is essential to devise communication strategies to raise awareness of TB and the available treatment services, and to counter stigma.
SOCIAL MOBILISATION AND ADVOCACY
2. TB-FREE - South Africa
This programme aims to increase TB awareness and compliance with the TB treatment regime by establishing TB FREE centres and training Directly Observed Therapy (DOT) supporters throughout South Africa. Implemented by the Aventis Foundation, the Nelson Mandela Foundation, and the South African National Department of Health, the 5-year programme also aims to raise awareness through community mobilisation and advocacy.
Contact info@tbfree.org
3. Advocacy, Communication and Social Mobilization to Fight TB: A Ten-year Framework for Action
This document sets out a 10-year strategic framework for country-level advocacy, communication and social mobilisation (ACSM) activities to exert pressure on governments and other high-level authorities to prioritise TB control. Offered by the ACSM Working Group (ACSM WG), the report emerges from the observation that there is an increasing wealth of experience and evidence demonstrating the value of ACSM in making progress toward meeting the Millennium Development Goal (MDG) related to TB (MDG #6) by: mobilising political support and leadership for TB control strategies at all levels (including at country level), empowering people affected by TB, improving case detection and boosting treatment adherence, and tackling stigma.
4. Confronting the Crisis of TB and HIV in Southern Africa An Advocacy Agenda for Governments, Health Care Workers, Researchers, Civil Society, Regional and International Agencies
To address the current TB crises in Southern Africa, 3 non-governmental organisations (NGOs) in southern Africa - the AIDS and Rights Alliance of Southern Africa (ARASA), the Southern African AIDS Treatment Access Movement (SATAMO), and the Treatment Action Campaign (TAC) - convened an Emergency Southern African Advocacy Summit on TB and HIV in August 2007 in Johannesburg, South Africa. This report of the meeting looks at the current situation, identifies barriers to the effective control of TB in the region, and includes a practical agenda for action to be taken by governments, healthcare workers, researchers, civil society, and national and international agencies.
5. Civil Society Perspectives on TB Policy in Bangladesh, Brazil, Nigeria, Tanzania, and Thailand
Published by the Open Society Institute (OSI)'s Public Health Watch project, this resource is part of a series of reports designed to highlight how social mobilisation can be an important communication strategy for addressing the fact that TB, HIV/AIDS, and poverty combine to cause almost 2 million preventable deaths every year. The series intends to demonstrate that health experts and policymakers alone cannot effectively combat TB. A key idea emerging out of these reports is that community participation and public awareness - which have lent vital support to the fight against HIV/AIDS, according to OSI - have (wrongly) been excluded from efforts to control the spread of TB.
6. Tuberculosis and Leprosy Control Programme
by Giannina Richeda, University of Brescia and the World Health Organization (WHO)
This document and an accompanying set of matrices, resulting from a collaborative academic agreement between the national Tuberculosis Control and Prevention Department of the Federal Ministry of Health (TLCP-MOH) of Ethiopia and the University of Brescia and World Health Organization (WHO), is a needs assessment for TB control in Ethiopia. It is part of the national level strategic plan on advocacy, communication, and social mobilisation (ACSM) for tuberculosis control and aims to offer a baseline tool document that, according to the author, functions to facilitate initial discussion for strategy building.
COMMUNITY PARTICIPATION
7. Contribution of 'TB clubs' to Tuberculosis Control in a Rural District in Ethiopia
by H. Getahun and D. Maher
This study aims to describe the contribution of ‘TB clubs’ (small support groups of patients based on where they live) to the performance of the TB control programme in Estie District in Ethiopia. The document offers a descriptive study of the formation of ‘TB clubs’, their contribution to case-finding, and the treatment outcomes before and after formation of the ‘TB clubs’. The findings showed that community participation through the formation of TB clubs contributed to more effective diagnosis and treatment of TB in the region.
8. The Omaheke Health and Education Programme (OHEP) - Namibia
This project, supported by Oxfam, worked in the sparsely populated area of Omaheke in Namibia targeting mainly the mobile San population. The community-based health initiative sought to decentralise TB control services by focusing on a primary health care system where outreach activities as well the active participation of the community were used to help treat TB patients, educate communities, and identify potential TB patients requiring treatment.
Contact info@oxfam.ca
9. Empowerment and Involvement of Tuberculosis Patients in Tuberculosis Control - Documented Experiences and Interventions
by Jean Macq, WHO and Stop TB Patnership
This publication from the World Health Organization (WHO) and the Stop TB Partnership is about empowering and involving patients with TB in the management of their disease. It presents the results of a review of available literature with the intention of identifying possible trends to inform policy and further research. The review of documented experiences covers the means used to enable patients to take more responsibility for their health and, in particular, for adherence to treatment; organising TB patients into groups and clubs; ensuring patient-centred TB and general health care; and helping TB patients to use advocacy to improve TB control.
10. Community Contribution to TB Care: Practice and Policy
The purpose of this document is to explore community participation in primary health care - specifically, in TB programming and policy. Offered by the World Health Organization (WHO), the report provides background, experiences, and policy recommendations in an effort to help National TB Programmes (NTPs) and community groups collaborate effectively to improve the delivery of TB care. It emerges from the "Community TB Care in Africa" project (conducted in 8 districts in 6 countries severely affected by TB/HIV - Botswana, Kenya, Malawi, South Africa, Uganda, and Zambia) - as well as reviews that WHO has commissioned in Asia and Latin America.
11. Under the Mupundu Tree
This book describes a home care programme in 23 low-income townships in Zambia’s Copperbelt. Coordinated by Ndola Catholic Diocese, the programme is said to have achieved high coverage, at reasonable cost, and has successfully integrated TB control into home care for people with HIV/AIDS and their families.
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Call for Papers
South Africa - Vrije Universiteit - Strategic Alliances (SAVUSA) is inviting scholars working in the areas of health communication or education to submit papers to be published in a proposed peer-reviewed book entitled: Communicating Health in Emerging Countries: Alternative Media and Appeals in Southern Africa.
In the proposed book, the publishers aim to present an overview of communication channels and strategies that account for specific conditions in emerging countries. The book aims to explore new opportunities and insights in health communication which may include new communication media (SMS, online social networking, video sites), alternative communication strategies (portrayal effects, specific appeals), and relevant distinctions between target groups (gender in specific cultures, ‘invisible’ groups).
Deadline for submission: June 23 2008
For more information contact Saskia Stehouwer at savusa@fsw.vu.nl or visit the SAVUSA website
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COMMUNICATION CAMPAIGNS, ICTS, AND THE MEDIA
12. The Compliance Service uses SMS Technology for TB Treatment
As noted within this case study, due to socio-economic and climatic factors, Cape Town has one of the highest TB infection rates in the world. The drug treatment regime for TB is difficult, but must be strictly followed in order to effectively treat the virus. Evidence suggests that in most cases TB patients fail to take their medication because they simply forget. The primary objective of this project is to alert TB patients to take their medication through the use of SMS, thereby increasing recovery rates of patients and lessening the financial and physical burden on the public healthcare system.
13. TB Behaviour Change Communication Project in Ghana - Ghana
In 2006, the Ghana Social Marketing Foundation (GSMF) undertook a behaviour change communication project which formed part of the broader Ghana National Tuberculosis Campaign strategy. Funded by The Global Fund, the project included the training of peer educators, peer education activities at transport hubs, and the development and positioning of giant TB billboards.
Contact Samuel Asiedu sagyei@gsmf.com.gh OR mail@gsmf.com.gh
14. Zambia Tuberculosis and Leprosy Trust (Zatulet) – Zambia
This non-governmental organisation (NGO) was formed to supplement government efforts in the fight against TB and leprosy in Zambia. The United Kingdom (UK)-based charity Target Tuberculosis sponsors the training of community volunteers and supports them in detecting, treating, preventing, and controlling TB and leprosy in the country. The project also trains youth peer educators, who work to raise awareness among young adults through the establishment of football and netball teams. The ultimate goal of this collaborative project is to empower Zambian communities with the skills and knowledge to prevent and treat TB.
Contact info@targettb.org.uk
15. Better Awareness Needed to Control TB Epidemic
by Angus Thomson
This article explores the strategy of controlling TB through active involvement of a well-informed civil society. This suggestion was a common theme within 5 reports released by the Open Society Institute's Public Health Watch initiative at the 37th World Congress on Lung Health, held in October/November 2006 in Paris, France. The reports identify the lack of awareness about TB as a major contributing factor to the disease's recent resurgence. According to the reports, this ignorance stems from the failure of governments, media, and civil society organisations (CSOs) to communicate the issues to the public and to high-risk groups such as the HIV-positive, including the fact that TB can be cured.
16. An Assessment of Factors Contributing to Treatment Adherence and Knowledge of TB Transmission Among Patients on TB Treatment: The Challenge of Ensuring Compliance with TB Treatment in Zambia
by Frederick AD Kaona, Mary Tuba, Seter Siziya and L. Sikaona
This research document, published in BMC Public Health, reports on a study which explored factors influencing non-adherence to TB treatment and knowledge of transmission among TB patients in Ndola, Zambia. The treatment guidelines followed the internationally recommended DOTS (directly observed treatment short-course) strategy. Key factors contributing to non-compliance included: patients beginning to feel better, lack of knowledge about the benefits of completing a course, running out of drugs at home, and patients finding TB drugs too strong. The report showed that there was little awareness of TB as an airborne disease and a common misconception that the disease was sexually transmitted.
17. TB in our Lives: A Book of Information Sheets for People Living with TB, Support Groups and Clinics
This handbook, written by Treatment Action Campaign (TAC) advocates, forms part of the TAC treatment literacy programme for South Africa. According to the publishers, this educational material was written for use in workshops and support groups and was intended for people living with TB, for healthcare workers, and treatment advocates.
18. TB and HIV - What the Papers Aren’t Saying
by Lucy Stackpool-Moore, Anushree Mishra and Ronald Kayanja - Panos Global AIDS Programme
This report on the need to enhance media coverage of TB argues that increasing mass media coverage of TB is crucial in helping to tackle the disease. Media coverage is one of the main ways people receive health information, and media coverage keeps TB on the public agenda so that health policymakers take notice. The paper is based on findings from a 2006 content analysis of print media in 12 countries, including South Africa, Zimbabwe, Tanzania, Kenya, Uganda, and Mozambique, which found little TB coverage in local or national print media, despite the fact that these countries rank among the highest TB burden countries in the world. The authors argue that the main reasons behind the lack of coverage are the health sector’s failure to engage with journalists adequately and the media’s unwillingness to prioritise health stories, despite TB being the leading cause of death among people living with HIV.
19. What Journalists Can Do in the Fight Against TB
by David Dickson
In this opinion-based article, the author names the two oft-quoted reasons for the upsurge in TB - the reduced immunity caused by HIV/AIDS, and the rise of drug resistant strains of TB. While recognising the increasing attention to TB control by international agencies he offers specifics about what more needs to be done. First, he names the need for more money to fill the funding gap for increasing TB prevention programmes. Second, he names raising awareness in both public and political communities. The article cites the role journalists play in informing people "about the nature and extent of this disease, the shortcomings in current treatments and future possibilities for improved control. Properly informed journalism can also create public pressure to spur politicians into action”.
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